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European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery · 2026

Tracheobronchial Replacement Using Cryopreserved Aortic Allografts: Results in 50 Patients (TRITON-01 Registry).

СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Martinod Emmanuel, Onorati Ilaria, Radu Dana M, Santos Portela Ana Maria, Peretti Marine, Bardet Jeremy, Maiolino Elena, Lo Torto Sara, Uzunhan Yurdagül, Freynet Olivia, Chouahnia Kader, Duchemann Boris, Brillet Pierre-Yves, Clero Dominique, Juvin Charles, Lebreton Guillaume, Rouard Hélène, Kabbani Jamal, Maurer Cyril, Gauthier Anne, Mangiapan Gilles, Dutau Hervé, Marquette Charles-Hugo, Malet Julie, Deslée Gaëtan, Galvaing Geraud, Chadeyras Jean-Baptiste, Tronc François, Gandher Cécile, Buffet Camille, Bensidhoum Morad, Miyara Makoto, Dard Nicolas, Besnard Valérie, Planès Carole, Trésallet Christophe, Fournier Clément, Vénissac Nicolas, Huet Olivier, Beloucif Sadek, Vicaut Eric

Аннотация

OBJECTIVES: Tracheal replacement remains a major challenge in thoracic surgery. We report the outcomes of the TRITON-01 registry, which includes 50 patients who underwent tracheal replacement using a cryopreserved aortic allograft performed by our surgical team.

METHODS: Prospective data were collected for each patient, including indication for surgery, operative details, postoperative mortality and morbidity, late complications, stent management, and patient status at last follow-up on January 2, 2025.

RESULTS: Between October 2009 and January 2025, 50 patients (25 females) with a mean age of 55.1 years (range, 20-79 years) underwent tracheal replacement. Extensive tracheobronchial lesions were malignant in 41 cases and benign in 9 cases. Veno-venous extracorporeal membrane oxygenation (ECMO) was used intraoperatively in 13 patients. Tracheobronchial reconstructions were classified as type 1, 2, 3, and 4 in 20, 15, 4, and 11 patients, respectively. Additional lung resections (lobectomy, bilobectomy, or pneumonectomy) were performed in 12 cases. Incomplete (R1) resection was observed in 3 patients. Thirty-day postoperative mortality was 4% (n = 2). Major complications occurred in 15 patients (30%). At the last follow-up (ranging from 1 month to 14 years), 74% of patients (n = 37) were alive. Stent-related granuloma formation was the most common late complication (n = 26), and stent removal was successfully achieved in 15 (30%) patients due to the development of functional neocartilage.

CONCLUSIONS: Tracheal replacement with cryopreserved aortic allografts appears to be an effective and sustainable technique, with acceptable mortality and morbidity rates. Ongoing investigations aim to optimize cartilage regeneration and enhance the bioavailability of grafts.

CLINICAL REGISTRATION NUMBER: Clinicaltrials.gov Identifier: NCT04263129.

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